What You Need to Know About In-Network vs. Out-of-Network Dental Coverage

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Filed under: Other Education

With multiple dental offices in your area, the task of finding a dentist may initially seem easy. However, to make a choice that is best for your oral health and your wallet, it is important to understand how dental insurance works. For example, what are the differences between in-network and out-of-network dentists? How can you determine which is best for your unique dental needs? If you’ve asked yourself something similar, read on!

How Do In-Network Dentists Work?

In-network dentists, also known as participating providers, are contracted with your insurance company to provide dental care at negotiated rates. So, if you choose an in-network dentist, you can get the cost of preventive services (like dental checkups and cleanings) completely covered. Even non-routine care, like fillings, typically require you to pay less at the time of service. Therefore, while your options may be more limited, you can enjoy fewer out-of-pocket expenses!

How Do Out-of-Network Dentists Work?

Unlike in-network providers, out-of-network dentists are not contracted with any insurance company. Although they don’t have pre-established rates, selecting a dentist outside your network can be beneficial because you can choose the one who suits your needs best! Plus, you may still be able to use your dental insurance to cover a portion of your treatment, but the money is reimbursed to your home instead of to your dental team.

So, Which Is Best?

Since there are a variety of pros and cons with each option, the answer to this question depends on your unique smile goals and budget. For example, if you want to pay less out-of-pocket while simultaneously enjoying more coverage and benefits, then visiting an in-network provider is likely the choice for you. On the other hand, if you want to upgrade your smile with cosmetic dentistry or have a dental need that necessitates complex treatment, a highly experienced, out-of-network provider may be the way to go.

Whether you decide to choose an in-network or out-of-network dentist, make sure to read the fine print on your dental plan to prevent unused coverage and wasted dollars. After all, many policies reset in January, which means there are only a few weeks left to maximize your coverage. So, don’t hesitate to get in contact with your dentist and ask about utilizing your dental insurance!

About the Practice

At Hamilton Family Dentistry, patients can enjoy a comfortable atmosphere, the latest technology, a world-class team, and a comprehensive array of services all under one roof. Plus, they are happy to work with all insurance companies and will even provide you with a complimentary benefits check at your first appointment! So, if you want to utilize your benefits before they reset, don’t hesitate to visit their website or give them a call at 706-801-4089.